A Fatal Case of Community Acquired Cupriavidus Pauculus Pneumonia

Abstract

Introduction: Cupriavidus pauculus is a rarely isolated non-fermentative, aerobic bacillus, which occasionally causes severe human infections, especially in immunocompromised patients. Strains have been isolated from various clinical and environmental sources. Case presentation: A 67-year-old man was admitted to the Intensive Care Unit with acute respiratory failure. The patient was diagnosed with bilateral pneumonia, pulmonary sepsis and underwent invasive mechanical ventilation. Examination revealed diminished bilateral vesicular breath sounds, fever, intense yellow tracheal secretions, a respiratory rate of 24/minute, a heart rate of 123/minute, and blood pressure of 75/55 mmHg. Vasoactive treatment was initiated. Investigations revealed elevated lactate and C-reactive protein levels. A chest X-ray showed bilateral infiltration. Parenteral ciprofloxacin and ceftriaxone were administered. Tracheal aspirate culture and blood culture showed bacterial growth of Cupriavidus pauculus. Colistin was added to the treatment. There was a poor clinical response despite repeated blood culture showing negative results. The diagnosis of multiple organ dysfunction syndrome (MODS) caused by C. pauculus was made. The patient died eleven days after admission. Conclusions: Clinical improvement cannot always be expected in spite of targeted antibiotic therapy. This pathogen should be considered responsible for infections that usually develop in immunocompromised patients.

Microbiological profile of ventilator-associated pneumonia among intensive care unit patients in tertiary Egyptian hospitals

“…It can be isolated from water and ultrafiltration systems of water in hospitals. C. pauculus rarely causes human infections, however, it may be an infectious agent in immunocompromised individuals causing bacteremia and peritonitis [32]. In this study, a single case positive culture showed the growth of C. pauculus; identified by Vitek 2 system.…”

“…In this study, a single case positive culture showed the growth of C. pauculus; identified by Vitek 2 system. In a previous study from Turkey, a VAP case was recorded to be caused by C. pauculus in a patient with breast cancer [32]. Thus, C. pauculus should be considered as a potential pathogen causing VAP infections, particularly in immunocompromised patients.…”

Cellulitis Caused by a Novel Cupriavidus Species Strain J1218 Identified by Whole Genome Sequencing

“…Patients infected with Cupriavidus species are usually immunocompromised [2,3,5,7]. Cases of infection with this genus have also been reported in elderly patients without obvious immunodeficiency [15,16].…”

“…Cupriavidus is a genus of aerobic gram-negative glucose-nonfermenting bacillus common in the environment but rarely isolated from clinical specimens. Clinical manifestations of infection with Cupriavidus species are varied and include pneumonia, bacteremia, meningitis, and septicemia in children [1][2][3].…”

“…Muscular abscess in a renal transplant recipient and airway infection with a Cupriavidus species in patients with cystic fibrosis suggest that immunodeficiency may be a prior condition for infection by this genus [3][4][5][6][7].…”